title: Vertebral compression fracture after stereotactic body radiotherapy for spinal metastases.
abstract: The use of stereotactic body radiotherapy for metastatic spinal tumours is increasing. Serious adverse events for this treatment include vertebral compression fracture (VCF) and radiation myelopathy. Although VCF is a fairly low-risk adverse event (approximately 5% risk) after conventional radiotherapy, crude risk estimates for VCF after spinal SBRT range from 11% to 39%. In this Review, we summarise the evidence and predictive factors for VCF induced by spinal SBRT, review the pathophysiology of VCF in the metastatic spine, and discuss strategies used to prevent and manage this potentially disabling complication.
authors.affiliation: Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada. arjun.sahgal@sunnybrook.ca
authors.forename: Arjun
authors.initials: A
authors.lastname: Sahgal
authors.forename: Cari M
authors.initials: CM
authors.lastname: Whyne
authors.forename: Lijun
authors.initials: L
authors.lastname: Ma
authors.forename: David A
authors.initials: DA
authors.lastname: Larson
authors.forename: Michael G
authors.initials: MG
authors.lastname: Fehlings
mesh_terms: D050815:Fractures, Compression / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D019637:Orthopedic Procedures; D018579:Patient Selection; D011237:Predictive Value of Tests; D011829:Radiation Dosage; D011832:Radiation Injuries / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D016634:Radiosurgery / Q000009:adverse effects*; D012086:Reoperation; D018570:Risk Assessment; D012307:Risk Factors; D016103:Spinal Fractures / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D013125:Spinal Neoplasms / Q000556:secondary / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome